SMILE for natural killer/T-cell lymphoma: analysis of safety and efficacy from the Asia Lymphoma Study Group.
نویسندگان
چکیده
Natural killer/T-cell lymphoma is rare and aggressive, with poor outcome. Optimal treatment remains unclear. A novel regimen dexamethasone, methotrexate, ifosfamide, l-asparaginase, and etoposide (SMILE) showed promise in phase 1/2 studies with restrictive recruitment criteria. To define the general applicability of SMILE, 43 newly diagnosed and 44 relapsed/refractory patients (nasal, N = 60, nonnasal, N = 21; disseminated, N = 6; male, N = 59; female, N = 28) at a median age of 51 years (23-83 years) were treated. Poor-risk factors included stage III/IV disease (56%), international prognostic index of 3 to 5 (43%), and Korean prognostic scores of 3 to 4 (41%). A median of 3 (0-6; total = 315) courses of SMILE were administered. Significant toxicities included grade 3/4 neutropenia (N = 57; 5 sepsis-related deaths); grade 3/4 thrombocytopenia (N = 36); and nephrotoxicity (N = 15; 1 acute renal failure and death). Interim analysis after 2 to 3 cycles showed complete remission rate of 56%, partial remission rate of 22%, giving an overall response rate of 78%. On treatment completion, the overall-response rate became 81% (complete remission = 66%, partial remission = 15%). Response rates were similar for newly diagnosed or relapsed/refractory patients. At a median follow-up of 31 months (1-84 months), the 5-year overall survival was 50% and 4-year disease-free-survival was 64%. Multivariate analysis showed that international prognostic index was the most significant factor impacting on outcome and survivals.
منابع مشابه
Extranodal NK/T Cell Lymphoma with Destruction of the Uvulae: A Case Report
Introduction: Extranodal Natural Killer (NK)/T-cell lymphoma (NKTCL) nasal type is a rare but well-known disease with poor prognosis. NKTCL is more prevalent in Asia and comprises about 7-10% of all non-Hodgkin lymphoma cases in this region. The characteristic clinical pattern of NKTCL is the destruction of the midline structures of the mid-face. Case Report: The present study examines a case o...
متن کاملImaging Case: NK/T-Cell Lymphoma, Nasal Type
Peripheral T-cell lymphomas are a group of heterogeneous disorders and according to WHO classification, are categorized into nodal and extranodal forms. NK/T-cell lymphoma, nasal type, is a subtype of extranodal peripheral T-cell lymphoma and commonly presents as a midfacial destructive lesion. This disorder is more prevalent in Asia and South America and has a strong association with Epstein B...
متن کاملDDGP versus SMILE in Newly Diagnosed Advanced Natural Killer/T-Cell Lymphoma: A Randomized Controlled, Multicenter, Open-label Study in China.
PURPOSE Optimal treatment strategies for advanced natural killer/T (NK/T)-cell lymphoma have not been fully defined. We compared the safety and efficacy of DDGP and SMILE regimens for advanced NK/T-cell lymphoma in a randomized controlled, multicenter, and open-label clinical trial. EXPERIMENTAL DESIGN Patients were newly diagnosed in stages III-IV and had performance scores in 0 to 2. Six cy...
متن کاملImmunophenotype evaluation of Non-Hodgkin’s lymphomas
Background: Non-Hodgkin’s lymphoma (NHLs) is known as a heterogeneous group of malignant lymphoproliferative disorders. NHLs are classified into B cell and T cell types. Immunophenotypical assessment of the biopsy specimens can help diagnose NHLs. Methods: In this study, 77 patients with B cell and T cell lymphoma were selected from Shahid Sadoghi hospital during 2010 to 2...
متن کاملEffects of Recombinant Urate Oxidase (Rasburicase) and Allopurinol for Prophylaxis and Treatment of Hyperuricemia in Patients with Leukemia and Lymphoma
Background: Efficacy of rasburicase in pediatric patients with leukemia and lymphoma is proved. This study aims toweigh efficacy and safety of rasburicase versus more conventional therapy, allopurinol, and to compare their safetyand properties in tumor lysis syndrome (TLS) of leukemia and lymphoma patients.Materials and Methods: The study was done with a retrospective cohort design. Patients we...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Blood
دوره 120 15 شماره
صفحات -
تاریخ انتشار 2012